| Objective: To compare open surgery and laparoscopic surgery for ovarian cyst endometriosis associated with infertility efficacy for treatment of ovarian endometriotic cyst with infertility the best surgical method for clinicians to provide treatment basis and reference.Methods: Retrospective analysis of the Sino-Japanese Friendship Hospital, Jilin University, Changchun City maternity hospital during 2006 with年1 January hospitalized in September 2008 confirmed ovarian endometriotic cysts and infertility, and fertile to the patients, 103 complete data cases. Both groups were ovarian endometriotic cystectomy. Of 103 cases of ovarian cyst with endometriosis infertile patients by surgical procedure were divided into two groups, of which 52 cases of laparoscopic surgery for the laparoscopic group; 51 regular open surgery for abdominal group. Preoperative two female hormone level and no abnormal basal body temperature measurement. Both groups were excluded organic reproductive tract abnormalities, uterine fibroids, ovarian tumors, germ cell tumor, and the line of routine examination of semen, male infertility factors ruled out. Preoperative hysterosalpingography were trekking check to see fallopian tube. And 1985, according to revised American Fertility Society staging method (R-AFS staging) were clinical stage. Two groups were compared before the experiment were age, infertility duration, clinical stage and fallopian tube, the results showed no significant (P> 0.05). The duration of each operation were evaluated, blood loss, anal exhaust time and hospital stay, assessment of dysmenorrhea, postoperative pain and chronic pelvic pain sexual intercourse three clinical remission, and to follow-up of patients after 18 months pregnancy rate and recurrence rate.Results: of laparoscopic group and open group, comparing perioperative: laparoscopic group operative time (43.5±19.2 min) and the abdominal operation time (77.3±21.2 min) compared with laparoscopic group was shorter than abdominal surgery The operation time, the difference was significant (P <0.05); laparoscopic group, the blood loss (54.6±20.6 ml) blood loss with open surgery group (121.6±34.5 ml) compared with laparoscopic group significantly reduced blood loss, the difference was significant (P <0.01); laparoscopic group anal exhaust time (15.2±4.7 h) and laparotomy group anal exhaust time ( 35.4±3.8 h) compared with laparoscopic group anal exhaust time earlier than the laparotomy group anal exhaust time, the difference was significant (P <0.05); and the laparoscopic group, the length of hospital stay (4.1±1.2 d) and open group of hospital stay (7.6±2.5 d) compared with laparoscopic group was significantly shorter hospital stay length of stay in the open surgery group, the difference was significant (P <0.01). Laparoscopic group and open group compared to the situation after symptoms: dysmenorrhea after laparoscopic group were remission rate (80.76%) in postoperative patients with abdominal dysmenorrhea response rate (83.35%) showed no significant difference (P > 0.05); laparoscopic group of patients with pain relief after sexual intercourse rate (84.44%) patients with postoperative abdominal pain remission rate of sexual intercourse (81.82%) showed no significant difference (P> 0.05); laparoscopic patients postoperative remission rate of chronic pelvic pain (67.31%) and abdominal postoperative patients with chronic pelvic pain response rate (68.63%), the difference was not significant (P> 0.05). Laparoscopic group compared with the pregnancy rate after laparotomy group: two groups of patients were followed up for 1 year and a half of pregnancy were compared, due to ovarian cyst endometriosis pregnancy rate and the preoperative clinical stage, the lesions severity is closely related to this study, laparoscopic group and open group of patients with various clinical stages of pregnancy and the overall pregnancy rate of the two groups were compared, the results in various clinical stages of patients, the laparoscopic group pregnancy rate after surgery than open surgery group, and the overall pregnancy rate after laparoscopic group (48.1%) was significantly higher than the overall pregnancy rate after laparotomy group (29.4%), the difference was significant (P <0.05 ). In addition, two groups of patients with postoperative pregnancy rate and clinical stage, that ovarian endometriosis cysts are clearly related to the severity of which mild ovarian endometriotic cyst (Ⅱperiod) of 21 patients with pregnancy cases, pregnancy rate was 53.8% (21/39), moderate ovarian endometriotic cyst (Ⅲperiod) were 16 cases of pregnancy, pregnancy rate was 35.6% (16/45), severe intrauterine ovary membrane cysts (Ⅳperiod) were 3 cases of pregnancy and after pregnancy rate was 15.8% (3 / 19), two groups of patients with pregnancy rate the severity of the lesions decreased, the difference was significant (P <0.05 ). Laparoscopic group and open group, spend more time after pregnancy: the laparoscopic group and open group of patients after pregnancy period is divided into: 6 months, 6 months to 1 year and 1 year of the three time periods , respectively, were compared in the three time periods and the cumulative pregnancy after pregnancy of the situation. Results in the laparoscopic group and open group, all patients were pregnant patients, most of the laparoscopic group (92.0%), and the vast majority of open surgery group (73.3%) were within 12 months after surgery pregnancy, more than 12 months after patients were significantly decreased pregnancy rate. Pregnancy after laparoscopic group of patients with 44.0% within 6 months after pregnancy, significantly higher than open surgery group 26.7%, the difference was significant (P <0.05), note than the laparoscopic group were able to open earlier patients were abdominal pregnancy. Laparoscopic group and open group, the recurrence rate comparison: two groups of patients were followed up for 1 year and a half of recurrence compared laparoscopic group, the recurrence rate was 9.6%, open surgery group recurrence was 9.8 % recurrence rate between the two groups were not significant (P> 0.05).Conclusion For all of other ovarian endometriotic cysts, laparoscopic surgery and open surgery to achieve the same therapeutic effect. Postoperative dysmenorrhea, dyspareunia and chronic pelvic pain can be effectively alleviated, and laparoscopic surgery to remove lesions more thoroughly, not to increase the recurrence rate in patients. Laparoscopic surgery for ovarian endometriosis cysts, compared with open surgery can significantly shorten the operation time, less blood loss and faster postoperative recovery in patients with anal discharge early, shorter hospital stay, and a minimally invasive characteristics of , less ovarian fallopian tube dysfunction, a low incidence of postoperative tubal adhesions and help patients access to pregnancy, ovarian cyst endometriosis infertile patients should be first choice for laparoscopic surgery. For ovarian endometrial cyst infertility after conservative surgery patients, patients after laparoscopic surgery than open surgery in patients with pregnancy, and laparoscopic surgery than open surgery allows patients earlier get pregnant. Ovarian endometriotic cyst with pregnancy after infertility patients with severe disease to reduce the severity. Ovarian endometriosis cysts and infertility patients received the golden time of pregnancy after 1 year, more than 1 year of pregnancy in patients with the opportunity to greatly reduced.
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